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A Real-World Study Comparing Advanced Hybrid Closed-Loop Systems During Pregnancy in Women with Type 1 Diabetes.

Carmen Quirós1, Ana M Wägner2, Sharona Azriel3

  • 1Hospital Universitari Mútua de Terrassa, Terrassa, Spain.

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Summary

Advanced hybrid closed-loop systems like CamAPS FX and Control-IQ showed better glucose control and reduced large-for-gestational-age infant risk in pregnant women with type 1 diabetes compared to MiniMed 780G.

Keywords:
HbA1cadvanced hybrid closed-loopcontinuous glucose monitoringmaternal–fetal outcomespregnancytype 1 diabetes

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Area of Science:

  • Endocrinology
  • Maternal-Fetal Medicine
  • Medical Technology

Background:

  • Type 1 diabetes management during pregnancy requires stringent glycemic control.
  • Advanced hybrid closed-loop (aHCL) systems offer improved glucose management.
  • Real-world data on different aHCL systems in pregnancy is crucial.

Purpose of the Study:

  • To compare maternal glucose metrics and pregnancy outcomes across three aHCL systems: MiniMed 780G, CamAPS FX, and Tandem Control-IQ.
  • To evaluate the effectiveness of these systems in a multicenter cohort of pregnant women with type 1 diabetes.

Main Methods:

  • A multicenter cohort study involving 137 pregnant women with type 1 diabetes using aHCL systems in Spain.
  • Participants were grouped by aHCL system: MiniMed 780G (n=85), CamAPS FX (n=38), and Control-IQ (n=14).
  • Maternal glucose metrics (HbA1c, time in/below/above range) and pregnancy outcomes (e.g., large-for-gestational-age infants) were analyzed using adjusted models.

Main Results:

  • CamAPS FX and Control-IQ users showed significantly lower HbA1c in the third trimester compared to MiniMed 780G users.
  • CamAPS FX use was associated with improved time in range and reduced time above range in the second trimester.
  • Both CamAPS FX and Control-IQ were linked to lower odds of delivering large-for-gestational-age infants compared to MiniMed 780G.

Conclusions:

  • CamAPS FX and Control-IQ systems demonstrated superior glycemic control and reduced risk of large-for-gestational-age infants in pregnant women with type 1 diabetes compared to MiniMed 780G.
  • These findings suggest potential benefits of specific aHCL systems for optimizing pregnancy outcomes.
  • Further research is warranted to confirm these associations and guide personalized clinical choices.